Acute Coronary Syndrome and Platelets Coagulation Biomarkers

Together with Professor Kini from the Department of Biological Science, NUS, the CVRI is leading a preclinical developmental study on variegin, a direct thrombin inhibitor intended for anticoagulation during percutaneous coronary intervention. In a partnership with colleagues from Duke-NUS and SLING, NUS, we have profiled the plasma lipidome of patients with acute coronary syndrome and identified sphingolipids as new prognostic biomarkers in acute coronary syndrome. We have further determined platelets to be an enriched source of circulating sphingolipids that can be modified by different intensities of antiplatelet therapy. The CVRI also leads in regional bioarchival efforts of blood and tissue samples from patients with stable and unstable coronary heart disease (n=3500 enrolled subjects with target of n=10,000); we emphasis longitudinal bioarchiving of patients with ACS so as to systematically accrue serial blood samples, paired with clinical and imaging phenotyping, out to 2 years after an acute coronary syndrome. The downstream goal of Improving acute coronary syndrome outcomes is evident in our population-based studies with the Singapore Myocardial Infarct Registry (National Registry of Disease Office) and an NMRC-funded randomised trial of telemedicine-based stepped care to reduce adverse remodelling in patients with recent ST-elevation myocardial infarction (IMMACULATE trial).